When I lived in China back in 2006-2007 I got around mostly by bike, as did many thousands of other people in my city. I never once wore a helmet, because no one else did. And that’s why it was extremely lucky that when I eventually got into an accident I did not land on my head. (Side note: As someone who is now older, wiser, and has worked in a hospital brain injury unit, I implore you to never, ever ride a bike without a helmet.)
Instead, I landed on my tailbone. After a few seconds of sitting stunned on the concrete, I stood up and walked the couple of steps to the curb. The guy on the electric bike who had hit me stopped to see if I was okay, and I told him I was. But the next morning I was in too much pain to go to work. So I took a taxi to the hospital. My Chinese friend Sylvia met me at the hospital to translate—a kindness for which I will be forever grateful, since I didn’t know enough Chinese to communicate anything useful, other than saying the word for “bicycle” and pointing at the base of my spine.
It’s hard to convey in writing what this hospital was like. I will begin by saying it looked exactly like what I would have expected a Communist hospital in a movie to look like, with large rooms and completely bare walls. But more interesting than the hospital’s lack of wall art was its lack of concern with privacy. Soon after our arrival, Sylvia and I were sent into a large examination room where several doctors were seated at desks and at least thirty random people—other patients and their family members—were milling around. When we approached one of the doctors, about half of the other people in the room crowded in a circle around us.
Sylvia explained to the doctor in Chinese about my accident, and the doctor said something back to her. “He wants you to pull down your pants,” said Sylvia. “What?” I said. The people crowding around us watched in silence. The doctor looked at me expectantly. So…I pulled down the back of my jeans partway, just enough so the doctor, and everyone else, could see the skin around my tailbone. (To be fair, staring is not really considered rude in China the way it is in Western cultures, and I got stared at a lot while I lived there…but being stared at while being examined by a doctor was a new one.)
Another notable thing about this hospital was its payment system. Sylvia and I went to three different rooms during our visit: an examination room, an x-ray room, and a pharmacy. Each room provided me with services (or medicine) and handed me a printed bill. We took the three bills to the cashier’s office near the exit. My total for the exam, x-rays, and two medications, was (if I remember correctly) about 250 Renminbi, or the equivalent of about 33 U.S. dollars.
So I paid my bill, and I took my x-rays and medications, and said thank you to Sylvia, and went back to my apartment, where I spent the next three weeks or so sitting on an airplane neck pillow, popping pills, reading Harry Potter books #1-#6, and waiting for my tailbone to heal.
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Why, oh why, am I telling you a story about a Chinese hospital and my tailbone on this Tuesday morning? Well, it’s because the topic I actually wanted to write about—health insurance costs—is a little dry and a little political, and I figured my Chinese hospital story might lure you into reading. And it worked. Haha.
Right, so: regarding health insurance.
From 2010 to 2015 I was enrolled in a student health plan at my university. It was fine—not great, but adequate. However, because I was graduating, it was due to disappear at midnight on Dec 31, 2015, and that meant that I needed to find something else from January 1st onward. I couldn’t get insurance through my job, because I didn’t have a job, and going without health insurance was not an option I was willing to consider. So in December I started exploring other options.
First I called my student health insurance provider and asked if I could go on COBRA. I was told, however, that my student health plan was in some kind of weird category that did not offer COBRA.
Now, I’m pretty sure that if this situation had happened in 1998, or 2002, or 2005, my only remaining option would have been to purchase a new individual health plan out of pocket—which probably would have been exorbitantly expensive. However, it wasn’t 1998, or 2002, or 2005. It was 2015. And that meant I had another option: MassHealth.
MassHealth is basically Massachusetts’s version of the Affordable Care Act, although, as you may be aware, it actually pre-dates the Affordable Care Act itself. I didn’t know much about the details of MassHealth, but a good friend of mine who had applied for it several years back told me her monthly premium had been estimated at $300, so I assumed it might be about the same for me.
So I went online, entered my information, and answered all the questions: single, unemployed, zero income. I called MassHealth to make sure I was interpreting the questions about employment correctly. Then I waited a couple days for the system to finish processing and called MassHealth again to ask what my monthly premium would be. Oh, it would be $0 per month, they said. Zero dollars. I asked the representative on the phone three times if she was sure it was free. She said yes.
Free health insurance.
I firmly believe that everyone deserves to get the healthcare they need, regardless of their financial situation, and I’ve believed for a long time that the best way to achieve this goal is for healthcare to be heavily subsidized and regulated by the government—even though this means higher taxes for me and for everyone else.
But this was the first time I had ever been an actual beneficiary of this type of system—and I was very grateful for it. MassHealth was basically a stopgap for me: I was not destitute, I had a small amount of money saved, and I knew that sooner or later I’d be able to find some sort of job. But my MassHealth benefits extended the amount of time I could support myself while searching for that job. And they made a huge difference in my peace of mind during the time that I was searching.
My apologies to anyone who didn’t think they were going to be reading a political blog post. I realize that not everyone is a fan of systems like MassHealth and the Affordable Care Act (and apologies, also, to my non-American readers for this rather American-centric post). But whatever your position on healthcare funding may be, I just wanted to share my experience with you, and you can make of it what you will.
As of this month, I’m on my new insurance through my new job. The premium is $113/month. Which I’m more than happy to pay.
PS: In case you’re wondering, the bike accident was largely my fault. I made an abrupt turn without signaling or checking to see if anyone was behind me.
PPS: You may also be wondering why a hospital located in the People’s Republic of China would employ a fee-for-service healthcare model and/or why my visit was so cheap. Unfortunately, I cannot answer either of these questions for you. My visit may have cost only $33 simply because the exchange rate at that time made everything seem super cheap; another possibility is that the fees were subsidized by the government. If you want to research the Chinese healthcare system circa 2006 and get back to me, go for it. 🙂